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X2020-2473 - Permits
City of Newport Beach - Building [ ivision 100 Civic Center Drive, Newport Beach, CA 926M - N Permit Counter Phone (949)644-3288 1; --- Inspection Requests Phone (949)644-3255 ''i+naia%`b Combination Type - SFP *X2020-2473* COMB Permit: X2020-2473 Project No : Issued Date : 10127/2020 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VAUD INSPECTION. PROJECTS MUST BE COMPLETED BY 10/28/2023 OR�II WILL BE INVALID Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on S n olidays Job Address:- 3 BALBOA COVES NB J'. Description: SFR - REROOF 15 SQ COMP/TEAR OFF COMP CL"A""Bv Legal Desc.: N TR 1011 LOT 3 Owner. FORTEVILLE RICHARD Contractor: OWNER/BLDR Architect: a Address: 3 BALBOA COVES Address: FORTEVILLE RICHARD Address: NEWPORT BEACH, CA 92663 O/B AUTH ATT Phone: 7141673-9005 Phone: Phone: State Lic: Applicant: FORTEVILLE RICHARD Con State Lic: 0/B aa5�/� Engine 040 ����'JC-rStateIO Address: 3 BALBOA COVES Lic Expire: Address: - NEWPORT BEACH, CA 92663 Bus Lic: g�ppp6 Phone: 7141673-9005 Lic Exp Date: Phone: ic:"®pip •• Code Edit: 2019 Worker's Compensation Insurance Designer: ��yy • ..... Type of Construction: VB Carrier Address: ON S����® • ®®° • Occupancy Group: R3/U Policy No: ° ° ®° ° Added /New sq.ft. Bldg: 0 Expire: Phone: 1 • ° ° . ° Added /New sq. ft. Garage: 0 ®° • , , No of Stories: . 2 Building Setbacks Rear: I Special Conditions: : ®• •° °„° No of Units: 1 Front: / •••o a ©o••• Bldg Height: 0 Left: / Bldg Sprinklers: Right: / 0000• Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $5,700.00 Building Permit Fee: $343.00 Excise Tax: $0.00 Planning Department - Fire Department ®°•• • • ° • Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: 600 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Aocess : $0.00 PNJ Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $344.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $344.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: GRADING APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or iRiWved for the purpose of sale). L�I A., as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra( ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least or sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Professions Code, is available upon request when this a o n ja sub ith 4eb site:http://www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION / jT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C and effect. License Class License No Date !RS' COMPENSATION DECLARATION . • FAILURE TO TO SE SECjIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE0. TO CRIMINAL OMPENSA IIONI DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. affirm EQder penalty of perjury one of the following declarations: and wig maintain a certificate of consent to self -insure for workers' compensation, issued by the I ce of Uie wgk for which this permit is issued. Policy No. and w0maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, carrier aad policy number are: Policy Number Agent for In 9fterformance of the work for which this permit is issued, I shall not employ any person in any bbcorne subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall °gnsture of AQ llicant IECLARATIONWGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for anders Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to meter th abov n ' d p pert o inspection purposes. Unnature of Prooertv Owner or Authorized Acent cif i .ewe Print Prooertv Owner's or ACTION I DATE I BY s sl REGULATIONS'PART 610 TIITLE 40 AND QMD RULECE WITH CODE OF FOR PERMITEXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED I I I QMD PERMITFINAL t t u Jf4 ASB TOS NOTIFIP�TION� IS NOT CERTIFICATE OF OP O DDEMOUTIW OCCUPANCYISSUED SIGNATURE: .�T���ii/�aN Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot legag, inderstand that a copy of the applicable law, Section 7044 of the Business and info.ca.gov/calaw.html. Dat v `� of Division 3 of the Business and Professions Code, and my license is in full force Contractor Signature AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date o as to become subject to the workers' compensation laws of California, and comply with those provisions. Date_ this permit is issued (Section 3097, Civil Code). USE ONLY